HomeMy WebLinkAboutX2019-4165 - Permit Applicationv
Worksheet for Combo Building & Solar Permit Application of a °
amm'I Residential City of Newport Beach - Building Division
NOTE: PLAN CHFCK FFFS DUE AT TIME OF SUBMITTAL °'�wa"'�
F-Building 1 Grading F-Drainage j Elec j Mech F_Plum Cu vd cuti— Cu Yd Fill
Project Address (Not mailing address) C Flood F Fire r Liq F_ Landslide I_. N/A Floor Suite No
F
92 1,,9
Description of Work
Use j ConstType
G
# Storiesj— # Units (if Res)j—
�nS!
Valuation $
Material/Labborl
New/Add SF Remodel SF 7i Garage/New/Add'
jf
OWNER'S NAME Last First j /�Ci}s14/Z✓ `/e%2:A�� `-�-'/
Owners Address Owners E-mail Address
j 27&&l 0,,, I .5 r- I
City 1_ �/�j;,ii_//L State _. _ Zip ! r7 7 Telephone q 3
APPLICANT'S NAME Last n l First '51 /
Applicant's Address Applicants E-mail Address
��1��✓S Rio 25 -31 �l7/a `c
TelephonCity qt�0�
,Zip cs
ARCHITECT/DESIGNER'S NAME Last i , Fi—[ Lic No.
, , r Iu �tec
Architect/Designers Address esigners E-mail Address
City I State Zip TelephoneF
ENGINEER'S NAME Last��/iL/✓ First! Lic � No. arJ �7
�0' c�
r
Engineers Address Engineers E-mail Address
�l
17 6d&zA1,O1f :.
Cam' f /�/�j State ,L-I Zip Telephone.
r�
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CONTRACTOR'S NAME/COMP/ANY Lic No.��Ig83Class
d/
1
Contractor's Address Contractors E-mail Address
J
���/� s7( .0 r� �_
�J
// /���_//
2 2
City rr1!OK/•A��14p14rrL, State Zip 9 TelePhonel //Y®I-32G
SETBACKS REAR SETBACKS FRONT PERMIT NO. 'Imv l' S O
PLAN CHECK NO. fJAI (Z ! )1
SETBACKS LEFT SETBACKS RIGHT
USE ZONE DFVFI OPMENT NO PLAN CHECK €€€S-